中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
24期
107-108,109
,共3页
翟丽佳%闵凤玲%周玮%高小惠%张丽娜
翟麗佳%閔鳳玲%週瑋%高小惠%張麗娜
적려가%민봉령%주위%고소혜%장려나
全血细胞减少%外周血涂片%骨髓检查
全血細胞減少%外週血塗片%骨髓檢查
전혈세포감소%외주혈도편%골수검사
Pancytopenia%Peripheral blood smear%Bone marrow examination
目的：探讨成人全血细胞减少性疾病的病因及临床特点，外周血、骨髓涂片及骨髓活检的意义。方法：对初诊150例全血细胞减少患者予血细胞形态、骨髓、铁蛋白、叶酸、维生素B12测定等进行分析。结果：150例患者中血液系统疾病占73.3%，巨幼细胞性贫血占16.6%，骨髓增生异常综合征占15.3%，急性白血病占14.6%，再生障碍性贫血占12.6%，多发性骨髓瘤占2.7%，淋巴瘤占4.0%，阵发性睡眠性血红蛋白尿占1.3%， EVENS综合征占0.6%，缺铁性贫血占5.3%。非血液系统疾病占26.7%，其中风湿系统疾病12.0%，脾功能亢进6.6%，感染3.3%，内分泌疾病2.0%，药物性占1.3%，肿瘤骨髓转移占1.3%。血细胞形态可对近一半血液系统疾病初步诊断，骨髓检查进一步明确。结论：全血细胞减少病因复杂，多为血液系统疾病，血涂片结合骨髓检查对诊断全血细胞减少有重要意义。
目的：探討成人全血細胞減少性疾病的病因及臨床特點，外週血、骨髓塗片及骨髓活檢的意義。方法：對初診150例全血細胞減少患者予血細胞形態、骨髓、鐵蛋白、葉痠、維生素B12測定等進行分析。結果：150例患者中血液繫統疾病佔73.3%，巨幼細胞性貧血佔16.6%，骨髓增生異常綜閤徵佔15.3%，急性白血病佔14.6%，再生障礙性貧血佔12.6%，多髮性骨髓瘤佔2.7%，淋巴瘤佔4.0%，陣髮性睡眠性血紅蛋白尿佔1.3%， EVENS綜閤徵佔0.6%，缺鐵性貧血佔5.3%。非血液繫統疾病佔26.7%，其中風濕繫統疾病12.0%，脾功能亢進6.6%，感染3.3%，內分泌疾病2.0%，藥物性佔1.3%，腫瘤骨髓轉移佔1.3%。血細胞形態可對近一半血液繫統疾病初步診斷，骨髓檢查進一步明確。結論：全血細胞減少病因複雜，多為血液繫統疾病，血塗片結閤骨髓檢查對診斷全血細胞減少有重要意義。
목적：탐토성인전혈세포감소성질병적병인급림상특점，외주혈、골수도편급골수활검적의의。방법：대초진150례전혈세포감소환자여혈세포형태、골수、철단백、협산、유생소B12측정등진행분석。결과：150례환자중혈액계통질병점73.3%，거유세포성빈혈점16.6%，골수증생이상종합정점15.3%，급성백혈병점14.6%，재생장애성빈혈점12.6%，다발성골수류점2.7%，림파류점4.0%，진발성수면성혈홍단백뇨점1.3%， EVENS종합정점0.6%，결철성빈혈점5.3%。비혈액계통질병점26.7%，기중풍습계통질병12.0%，비공능항진6.6%，감염3.3%，내분비질병2.0%，약물성점1.3%，종류골수전이점1.3%。혈세포형태가대근일반혈액계통질병초보진단，골수검사진일보명학。결론：전혈세포감소병인복잡，다위혈액계통질병，혈도편결합골수검사대진단전혈세포감소유중요의의。
Objective:To probe the causes of pancytopenia in adults and their clinical characteristics,and the significance of peripheral blood,bone marrow smear and bone marrow biopsy as well.Method:In the article,150 first-time patients with pancytopenia were analyzed for the determination of blood cell forms,bone marrow,ferritin,folic acid and vitamin B12.Result:Of the 150 relapsed cases,hematological systemic diseases account for 73.3%,including 16.6%with megaloblastic anemia,14.6%with acute leukemia,15.3%with myelodysplastic syndrome(MDS),12.6%with aplastic anemia,2.7%with multiple myeloma, 4.0%with lymphoma,1.3%with paroxysmal nocturnal hemoglobinuria(PHN),0.6%with EVENS syndrome,5.3%with iron deficiency anemia,while non-blood systemic diseases account for 26.7%,including hypersplenism(6.6%),infection(3.3%),rheumatic disease(12.0%),endocrine disease(2.0%),drug-induced disease(1.3%) and tumors with bone marrow metastasis(1.3%). Nearly half of the hematological systemic diseases can be diagnosed preliminarily through blood cell forms and bone marrow be further defined.Conclusion:There are many complicated causes to induce pancytopenia,most of which are from hematological systemic diseases. Blood smear with bone marrow examination has important significance for the diagnosis of pancytopenia.
